The Institute for Clinical and Translational Science (ICTS) at the University of Iowa (UI) was established by the Board of Regents to realize three objectives ? first, to lead the development of translational science at the UI; second, to advance translational science as a distinct academic discipline; and third, to disseminate capacities in translational science across the State of Iowa. This mandate enabled us to tackle large problems affecting translational science that required institutional solutions, such as transforming regulatory processes for human subjects research, developing an informatics infrastructure for integrating electronic medical record and other health care data, establishing bi-directional relationships with community organizations, and revitalizing the pipeline of well trained clinical and translational researchers. Iowa is a rural state, which brings special health care needs and challenges. We have used these rural considerations as a catalyst for driving our approach to clinical and translational research pushing our teams to develop strategies to engage rural populations of all ages and backgrounds and to create new approaches that overcome the geographic barriers in a rural state. We are capitalizing on our established community practice networks of family physicians, clinics, school nurses and pharmacists. We utilize e Health/ e Learning platforms in novel ways and will test the efficacy of these new methods of engagement. As we move research ?Beyond Our Borders,? we have created methods to capture real-time, real-life data from the home and to correlate this environmentally specific, comprehensive data to human performance. The ICTS is engaging with other CTSA hubs and national CTR systems to empirically test different approaches and to develop the evidence base of proven strategies for accelerating translation that can be more broadly disseminated. Though distance and rurality drive our approaches, the strategies that we develop are simply new and potentially better ways to generate broad representation and improved participation by patients, healthcare teams and academicians. Through our local, state and national partnerships, UI and the ICTS are poised to move clinical and translational discovery rapidly into healthcare practice in a variety of clinical settings.